Page 34 - Virtual Vascular Vol 9
P. 34

Ruptured Internal Iliac aneurysm














                                                                                                                                                  Philipps.mp4



















































                                                                                                                                     This 72-year old Caucasian gentleman presented with progressive lower abdominal
                                                                                                                                     pain and groin pain for 3 days.  CT scan showed that he had huge bilateral internal
                                                                                                                                     iliac artery aneurysms filling the entire pelvis, with evidence of leaking from the
                                                                                                                                     10cm LIIA aneurysm.  His entire aorta is dilated with a suprarenal aneurysm origi-
                                                                                                                                     nating in the lower thoracic aorta, involving the CA/SMA common trunk, and both
                                                                                                                                     renal arteries.



                                                                                                                                     This is a very challenging situation due to the need to revascularize the visceral ves-
                                                                                                                                     sels at the top, as well as to control and repair the internal iliacs at the deep pelvis.
                                                                                                                                     Revascularization of at least one internal iliac is also preferable to prevent pelvic
                                                                                                                                     ischemia and bowel gangrene.

        34                                                                                                                                                                                                                            35
   29   30   31   32   33   34   35   36   37   38   39